Alveolectomy: Bone Recontouring for All-on-4® Teeth
Posted on: April 1, 2025
BackAlveolectomy: Bone Recontouring for All-on-4® Teeth
5 minute read
Major tooth loss can have a number of adverse effects, including deterioration of the jaw bone. If you’re missing a number of teeth, the teeth roots will no longer be present to stimulate bone growth, which can lead to shrinking of the jaw and other facial structures.
If you choose to replace missing teeth with All-on-4® dental implants, your dentist will perform an alveolectomy at the same time to reshape your jaw bone and create a flat surface that is ready to support dental implants and your new teeth.
Read more about what’s involved in an alveolectomy and implant procedures below or get in touch with our dentists in Kelmscott and East Vic Park to discuss whether All-on-4® implants are a suitable option for you.
What is an alveolectomy?
An alveolectomy is performed on the alveolar bone. This is the part of the jawbone where the roots of teeth connect and grow. This bone structure is flexible to accommodate the changing size and shape of teeth as they develop. When teeth are lost, the bone can start to deteriorate and lose its shape.
During an alveolectomy, a dentist reshapes the alveolar bone and removes infected and unhealthy tissue to create enough space and provide a stable and supportive foundation for dental implants. This can help to preserve the shape and structure of the jawbone for a more natural-looking smile. It also makes it easier to clean your new teeth.
Is alveolectomy always needed?
An alveolectomy is a standard procedure that’s always performed when replacing a full arch of teeth with dental implants. It helps to ensure that the implants have enough support from the jaw, improves connections with the underlying bone to aid the healing process, and creates a flat surface for replacement teeth, leading to a better fit and aesthetic results.
The alveolectomy is performed at the same time the implants are placed. If you want to know more about this procedure or any stage of the All-on-4® process, contact our dentists.
All-on-4® treatment process: step by step
If you’re considering All-on-4® implants to replace missing teeth, your dentist will explain the procedure so you know what to expect at every stage. At Perth Dental Implant Centre, the process is as follows:
1. Consultation and planning
2. Alveolectomy procedure to prepare the jaw for All-on-4® implants and teeth
3. Placing your All-on-4® implants
4. Trying in your bridge
5. Fitting your permanent bridge
6. Review and follow-up care
While most other dental implant systems involve waiting up to 6 months for implants to bond with the jaw, this is avoided with All-on-4® implants, due to the way the implants are positioned. The trademarked All-on-4® surgical protocol allows a fixed full mouth implant bridge to be fitted within five days of surgery.
1. Consultation and planning
It’s essential that you have all the information about All-on-4® and alternative options before you decide on treatment, which is why the process begins with an in-depth consultation with your surgeon.
During this visit, your dentist will discuss your needs and goals from the treatment, examine your mouth and jaw, and ask about your medical history and other factors to determine whether you’re eligible for the procedure or if you might benefit from an alternative solution. This will involve the use of 3D x-rays and taking other images and impressions of your mouth to assess the density and quality of bone in your jaw.
If you have been without natural teeth for some time, you may have experienced significant jawbone loss. In this case, your dentist will discuss the likelihood or having additional implants or longer implants placed such as pterygoid or zygomatic implants in the upper jaw to better support replacement teeth.
If you’re suitable for All-on-4® implants and decide to go ahead, your dentist will tailor your treatment plan with details such as times and costs.
Following this appointment, you’ll have pre-surgery records taken and you’ll also meet your dental technician to choose the shape and shade of your teeth.
2. Alveolectomy procedure to prepare the jaw for All-on-4® teeth
On the date of your surgery, your dentist will first remove any remaining teeth and will perform the alveolectomy to recontour the jawbone and create a flat surface for your replacement teeth. This will involve making incisions in the gum to access the jawbone.
3. Placing your All-on-4® implants
Once the jawbone has been prepared, your implants can be carefully placed inside, using freehand or digitally-guided surgery. The All-on-4® system uses four or more Nobel Biocare implants per arch that are positioned at the back and front of the jaw. Your dentist will then attach the abutments to the implants and stitch the gum closed.
After surgery, your dentist will take impressions of the implants and abutments in your mouth that will be used when creating your bridge. Healing caps will then be placed over the top of dental implants.
4. Trying in your bridge
After 1–3 days, a wax-up trial model of your new teeth will be prepared for you to try. Your dentist will check their fit, appearance and how they bite together, and will note any adjustments that may be needed for your final bridge.
5. Fitting your permanent bridge
Within five days of surgery, your titanium-acrylic bridge is fitted. Your dentist will attach the new teeth to the implant abutments and check their fit and make any necessary adjustments. They will explain how to care for your implants and your oral health during the healing period and in the long term to avoid complications.
6. Follow-up care
All-on-4® dental implants have a high success rate, but comprehensive aftercare is an important part of the process. Your dentist will schedule a follow-up appointment after four weeks and twelve weeks to check your implants, speech and bite and to ensure you’re healing well.
Every 6 to 12 months, you’ll attend a check-up and your bridge will be professionally cleaned you’re your dentist or hygienist. Every 12 to 24 months, you’ll have x-rays taken to check the bone surrounding your dental implants.
What are the benefits of All-on-4® implants?
At Perth Dental Implant Centre, we offer genuine All-on-4® implants by Nobel Biocare. All-on-4® is a well-recognised brand, but few people may realise that the All-on-4® trademark covers the surgical protocol and the implants, themselves.
The All-on-4® procedure has a 98% success rate and the most clinical studies supporting its effectiveness.* The All-on-4® protocol avoids the need for bone grafting in most cases, which may be necessary with other implant treatments.
If you need to replace all of your upper or lower teeth, All-on-4® implants offer a number of advantages over removable dentures. These include:
• Superior support and stability for replacement teeth
• Look and function just like natural teeth
• Stronger biting forces allowing you to enjoy a wider range of foods
• Help stimulate the jawbone, preventing bone loss
• May lower the risk of gums receding
• Won’t require a separate cleaning routine like dentures do
• Longer lifespan with proper care
While dental implants show many benefits, they are not suitable for everyone. The advantage of dentures over implants include avoiding surgery and associated surgical risks and lower treatment and maintenance costs.
Learn more about the pros and cons of suction dentures, overdentures and All-on-4® dental implants in our blog.
Choosing your All-on-4® bridge
Some dental clinics place a temporary All-on-4® bridge after surgery, which typically needs to be replaced within 6 to 12 months. At Perth Dental Implant Centre, we take a more streamlined, single-stage approach to avoid the added cost and inconvenience of a temporary bridge. Within five days of surgery, we place a titanium-reinforced acrylic bridge that offers a passive fit to support better implant healing and is significantly stronger than a standard temporary acrylic bridge. While a traditional acrylic bridge usually requires replacement with a permanent bridge within the first year, a titanium-reinforced acrylic bridge can last 2 to 5 years or even longer before needing to be replaced.
When it’s time to replace your titanium-acrylic bridge, you’ll have a choice of tooth materials depending on your needs and price range. You may choose a new or remodelled titanium-acrylic bridge or upgrade to a titanium-reinforced zirconia bridge or porcelain-layered zirconia bridge for superior aesthetics and durability.
Learn more about All-on-4® bridge options in our blog.
How to care for your All-on-4® teeth
You can help your All-on-4® teeth to last for as long as possible by maintaining good oral hygiene and healthy habits. This includes:
• Brushing your teeth and gums twice daily to help prevent gum disease
• Cleaning between your teeth using a water flosser or other non-abrasive cleaning tool
• Avoiding too much added sugar in your diet
• Drinking plenty of water every day
• Not smoking, which is a risk factor for implant failure
• Visiting the dentist every 6 months for a check-up and clean
The alveolectomy procedure creates a flat profile for your All-on-4 teeth that makes them easy to clean. If you grind your teeth while you sleep, your dentist may recommend wearing a night splint to protect your teeth at night.
Find out more about All-on-4® implants in Perth
If you have more questions about the All-On-4 process, or you want to talk to us about your treatment, call Perth Dental Implant Centre today on 1300 108 133. We have three local dental clinics in East Victoria Park, Kelmscott and Mount Lawley, and we welcome new patients from all surrounding areas.
The total cost of All-on-4® dental implants includes the cost of the implants as well as the first and subsequent sets of replacement teeth, implant surgery, diagnostics and other services as required, such as dental sedation. There will also be ongoing maintenance costs to consider, including professional cleaning and bridge repairs as needed.
How long your All-on-4® bridge will last before it needs to be replaced depends on the type of bridge you choose and your oral hygiene, biting forces and lifestyle factors.
References
1. Malo P, de Araújo Nobre M, Lopes A, Moss SM, Molina GJ. A longitudinal study of the survival of All-on-4® implants in the mandible with up to 10 years of follow-up. J Am Dent Assoc 2011;142:310-204
2. https://www.sciencedirect.com/topics/immunology-and-microbiology/alveolar-bone
